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[PMID]:29145990
[Au] Autor:Sethi P; Franco WG
[Ad] Endereço:ONS Sports and Shoulder Service, ONS Foundation for Clinical Research and Education, 6 Greenwich Office Park, 40 Valley Drive, Greenwich, CT 06831, USA. Electronic address: sethi@onsmd.com.
[Ti] Título:The Role of Superior Capsule Reconstruction in Rotator Cuff Tears.
[So] Source:Orthop Clin North Am;49(1):93-101, 2018 Jan.
[Is] ISSN:1558-1373
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Massive, irreparable rotator cuff disease is a challenging problem to treat, especially in the younger active patient. This condition allows the deltoid to generate anterosuperior translation and shoulder dysfunction. Ideally, this dysfunction may be improved with rotator cuff repair. However, in the setting of irreparable rotator cuff disease, normal function is challenging to restore. Superior capsule reconstruction theoretically improves function by recentering the humeral head and improving glenohumeral kinematics. This restoration of stability results in a stable fulcrum, and may allow the deltoid and remaining cuff can function more effectively.
[Mh] Termos MeSH primário: Artroplastia
Cápsula Articular/cirurgia
Lesões do Manguito Rotador/cirurgia
Articulação do Ombro/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171118
[St] Status:MEDLINE


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[PMID]:28976430
[Au] Autor:Guenther D; Irarrázaval S; Bell KM; Rahnemai-Azar AA; Fu FH; Debski RE; Musahl V
[Ad] Endereço:1Orthopaedic Robotics Laboratory (D.G., S.I., K.M.B., A.A.R.-A., F.H.F., R.E.D., and V.M.) and Departments of Orthopaedic Surgery (D.G., S.I., A.A.R.-A., F.H.F., and V.M.) and Bioengineering (K.M.B. and R.E.D.), University of Pittsburgh, Pittsburgh, Pennsylvania 2Trauma Department, Hannover Medical School (MHH), Hannover, Germany.
[Ti] Título:The Role of Extra-Articular Tenodesis in Combined ACL and Anterolateral Capsular Injury.
[So] Source:J Bone Joint Surg Am;99(19):1654-1660, 2017 Oct 04.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The "gold standard" treatment of anterolateral capsular injuries in anterior cruciate ligament (ACL)-deficient knees has not been determined. The purpose of this study was to determine the effects of ACL reconstruction and extra-articular reconstruction on joint motion in the ACL-deficient knee and in the combined ACL and anterolateral capsule-deficient knee. METHODS: An anterior tibial load of 134 N and internal tibial torque of 7 Nm were applied to 7 fresh-frozen cadaveric knees using a robotic testing system continuously throughout the range of flexion. The resulting joint motion was recorded for 6 knee states: intact, ACL-deficient, ACL-reconstructed, combined ACL and anterolateral capsule-deficient, ACL-reconstructed + anterolateral capsule-deficient, and ACL-reconstructed + extra-articular tenodesis. RESULTS: Anterior tibial translation of the ACL-reconstructed + anterolateral capsule-deficient knee in response to an anterior tibial load was restored to that of the intact knee at all knee-flexion angles (p > 0.05). However, for this knee state, internal tibial rotation in response to internal tibial torque was not restored to that of the intact knee at 60° or 90° of knee flexion (p < 0.05). For the knee state of ACL-reconstructed + extra-articular tenodesis, internal rotation in response to internal tibial torque was restored to the motion of the intact knee at each of the tested knee-flexion angles (p > 0.05). Compared with the intact knee, 2 of 7 specimens showed decreased internal tibial rotation with ACL reconstruction + extra-articular tenodesis. CONCLUSIONS: In this study, an extra-articular tenodesis was necessary to restore rotatory knee stability in response to internal tibial torque in a combined ACL and anterolateral capsule-deficient knee. The amount of rotatory knee instability should be carefully assessed to avoid over-constraint of the knee in these combined ligament-reconstruction procedures. CLINICAL RELEVANCE: On the basis of our findings, the surgical procedure needs to be personalized depending on the amount of rotatory knee instability in the injured knee and the amount of rotation in the contralateral knee.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/cirurgia
Reconstrução do Ligamento Cruzado Anterior/métodos
Cápsula Articular/lesões
Traumatismos do Joelho/cirurgia
Tenodese/métodos
[Mh] Termos MeSH secundário: Lesões do Ligamento Cruzado Anterior/complicações
Cadáver
Seres Humanos
Traumatismos do Joelho/complicações
Meia-Idade
Amplitude de Movimento Articular
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01462


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[PMID]:28790026
[Au] Autor:Tak PP; Doorenspleet ME; de Hair MJH; Klarenbeek PL; van Beers-Tas MH; van Kampen AHC; van Schaardenburg D; Gerlag DM; Baas F; de Vries N
[Ad] Endereço:Department of Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
[Ti] Título:Dominant B cell receptor clones in peripheral blood predict onset of arthritis in individuals at risk for rheumatoid arthritis.
[So] Source:Ann Rheum Dis;76(11):1924-1930, 2017 Nov.
[Is] ISSN:1468-2060
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The onset of seropositive rheumatoid arthritis (RA) is preceded by the presence of specific autoantibodies in the absence of synovial inflammation. Only a subset of these individuals will develop clinical disease. This impedes efforts to implement early interventions that may prevent onset of clinically manifest disease. Here we analyse whether clonal changes in the B cell receptor (BCR) repertoire can reliably predict onset of signs and symptoms. METHODS: In a prospective cohort study in 21 individuals at risk for RA based on the presence of autoantibodies, the BCR repertoire of paired peripheral blood and synovial tissue samples was analysed using next-generation BCR sequencing. BCR clones that were expanded beyond 0.5% of the total repertoire were labelled dominant. The relative risk (RR) for onset of arthritis was assessed using the presence of ≥5 dominant BCR clones as cut-off. Findings in peripheral blood were validated in an independent prospective cohort of 50 individuals. Based on the test cohort, individuals in the validation cohort were considered positive if peripheral blood at study entry showed ≥5 dominant BCR clones. FINDINGS: Both in the test and validation cohort, the presence of ≥5 dominant BCR clones in peripheral blood was significantly associated with arthritis development after follow-up (validation cohort RR 6.3, 95% CI 2.7 to 15, p<1×10 ). Even when adjusted for a recently described clinical prediction rule the association remained intact (RR 5.0, 95% CI 1.2 to 20, p=0.024). When individuals developed arthritis, dominant BCR clones disappeared from peripheral blood and appeared in synovial tissue, suggesting a direct role of these clones in disease pathogenesis. INTERPRETATION: Dominant BCR clones in peripheral blood predict onset of clinical signs and symptoms of RA in individuals with high accuracy. Our data suggest that during onset of RA these clones shift from peripheral blood to the target tissue.
[Mh] Termos MeSH primário: Artrite Reumatoide/imunologia
Receptores de Antígenos de Linfócitos B/sangue
[Mh] Termos MeSH secundário: Adulto
Autoanticorpos/análise
Autoanticorpos/imunologia
Células Clonais
Feminino
Seguimentos
Seres Humanos
Cápsula Articular/imunologia
Masculino
Meia-Idade
Valor Preditivo dos Testes
Estudos Prospectivos
Receptores de Antígenos de Linfócitos B/genética
Risco
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Receptors, Antigen, B-Cell)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE
[do] DOI:10.1136/annrheumdis-2017-211351


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[PMID]:28514214
[Au] Autor:Linklater JM; Hayter CL; Vu D
[Ad] Endereço:From Castlereagh Imaging, 60 Pacific Hwy, St Leonards, Sydney, NSW, Australia 2065 (J.M.L., C.L.H.); and Department of Anatomy, School of Medical Science, University of Notre-Dame Australia, Sydney, Australia (D.V.).
[Ti] Título:Imaging of Acute Capsuloligamentous Sports Injuries in the Ankle and Foot: Sports Imaging Series.
[So] Source:Radiology;283(3):644-662, 2017 Jun.
[Is] ISSN:1527-1315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The ankle and foot are commonly injured during sporting activities. Clinical diagnosis can at times be challenging, due to the complex anatomy and multiple sites of potential injury. In the athlete, there is a reduced threshold for imaging to clarify diagnosis, guide prognosis, and treatment. Diagnostic imaging is also helpful in evaluating ongoing symptoms in the subacute or chronic setting. RSNA, 2017.
[Mh] Termos MeSH primário: Traumatismos do Tornozelo/diagnóstico por imagem
Traumatismos em Atletas/diagnóstico por imagem
Traumatismos do Pé/diagnóstico por imagem
Cápsula Articular/diagnóstico por imagem
Cápsula Articular/lesões
Ligamentos Articulares/diagnóstico por imagem
Ligamentos Articulares/lesões
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE
[do] DOI:10.1148/radiol.2017152442


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[PMID]:28488536
[Au] Autor:Marx C; Tamborrini G
[Ad] Endereço:1 Ultraschall Zentrum Rheumatolgoie Basel.
[Ti] Título:CME-Rheumatologie 12/Auflösung: Osteonekrose des Humeruskopfes..
[So] Source:Praxis (Bern 1994);106(10):551-552, 2017.
[Is] ISSN:1661-8157
[Cp] País de publicação:Switzerland
[La] Idioma:ger
[Mh] Termos MeSH primário: Bursite/diagnóstico por imagem
Cabeça do Úmero/diagnóstico por imagem
Cabeça do Úmero/lesões
Traumatismos Ocupacionais/diagnóstico por imagem
Osteonecrose/diagnóstico por imagem
Periartrite/diagnóstico por imagem
Síndrome de Colisão do Ombro/diagnóstico por imagem
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Seres Humanos
Cápsula Articular/diagnóstico por imagem
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Pasteurização
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170511
[St] Status:MEDLINE
[do] DOI:10.1024/1661-8157/a002665


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[PMID]:28410619
[Au] Autor:Thomsen LN; Thomsen PD; Downing A; Talbot R; Berg LC
[Ad] Endereço:Department of Veterinary Clinical Sciences, University of Copenhagen, Hoejbakkegaards alle 5, 2630, Taastrup, Denmark.
[Ti] Título:FOXO1, PXK, PYCARD and SAMD9L are differentially expressed by fibroblast-like cells in equine synovial membrane compared to joint capsule.
[So] Source:BMC Vet Res;13(1):106, 2017 Apr 14.
[Is] ISSN:1746-6148
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The synovial membrane lines the luminal side of the joint capsule in synovial joints. It maintains joint homeostasis and plays a crucial role in equine joint pathology. When trauma or inflammation is induced in a joint, the synovial membrane influences progression of joint damage. Equine synovial membrane research is hampered by a lack of markers of fibroblast-like synoviocytes (FLS) to distinguish FLS from other fibroblast-like cells in musculoskeletal connective tissues. The aim of this study is to identify potential FLS markers of the equine synovial membrane using microarray to compare between gene expression in equine synovial membrane and the joint capsule in metacarpophalangeal joints. RESULTS: Microarray analysis of tissues from 6 horses resulted in 1167 up-regulated genes in synovial membrane compared with joint capsule. Pathway analysis resulted in 241 candidate genes. Of these, 15 genes were selected for further confirmation as genes potentially expressed by fibroblast-like synoviocytes. Four genes: FOXO1, PXK, PYCARD and SAMD9L were confirmed in 9 horses by qPCR as differentially expressed in synovial membrane compared to joint capsule. CONCLUSIONS: In conclusion, FOXO1, PXK, PYCARD and SAMD9L were confirmed as differentially expressed in synovial membrane compared to joint capsule. These four genes are potential markers of fibroblast-like synoviocytes of the synovial membrane. As these genes are overexpressed in synovial membrane compared to joint capsule, these genes could shed light on synovial membrane physiology and its role in joint disease.
[Mh] Termos MeSH primário: Biomarcadores/metabolismo
Fibroblastos/metabolismo
Cavalos/metabolismo
Cápsula Articular/metabolismo
Membrana Sinovial/metabolismo
Sinoviócitos/metabolismo
[Mh] Termos MeSH secundário: Animais
Regulação da Expressão Gênica
Cápsula Articular/citologia
Reação em Cadeia da Polimerase em Tempo Real
Membrana Sinovial/citologia
Análise Serial de Tecidos
Regulação para Cima
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170416
[St] Status:MEDLINE
[do] DOI:10.1186/s12917-017-1003-x


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[PMID]:28385944
[Au] Autor:Henderson ER; Keeney BJ; Pala E; Funovics PT; Eward WC; Groundland JS; Ehrlichman LK; Puchner SS; Brigman BE; Ready JE; Temple HT; Ruggieri P; Windhager R; Letson GD; Hornicek FJ
[Ad] Endereço:The Geisel School of Medicine at Dartmouth College, One Medical Center Drive, Lebanon, NH 03756, USA.
[Ti] Título:The stability of the hip after the use of a proximal femoral endoprosthesis for oncological indications: analysis of variables relating to the patient and the surgical technique.
[So] Source:Bone Joint J;99-B(4):531-537, 2017 Apr.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Instability of the hip is the most common mode of failure after reconstruction with a proximal femoral arthroplasty (PFA) using an endoprosthesis after excision of a tumour. Small studies report improved stability with capsular repair of the hip and other techniques, but these have not been investigated in a large series of patients. The aim of this study was to evaluate variables associated with the patient and the operation that affect post-operative stability. We hypothesised an association between capsular repair and stability. PATIENTS AND METHODS: In a retrospective cohort study, we identified 527 adult patients who were treated with a PFA for tumours. Our data included demographics, the pathological diagnosis, the amount of resection of the abductor muscles, the techniques of reconstruction and the characteristics of the implant. We used regression analysis to compare patients with and without post-operative instability. RESULTS: A total of 20 patients out of 527 (4%) had instability which presented at a mean of 35 days (3 to 131) post-operatively. Capsular repair was not associated with a reduced rate of instability. Bivariate analysis showed that a posterolateral surgical approach (odds ratio (OR) 0.11, 95% confidence interval (CI) 0.02 to 0.86) and the type of implant (p = 0.046) had a significant association with reduced instability; age > 60 years predicted instability (OR 3.17, 95% CI 1.00 to 9.98). Multivariate analysis showed age > 60 years (OR 5.09, 95% CI 1.23 to 21.07), female gender (OR 1.73, 95% CI 1.04 to 2.89), a malignant primary bone tumour (OR 2.04, 95% CI 1.06 to 3.95), and benign condition (OR 5.56, 95% CI 1.35 to 22.90), but not metastatic disease or soft-tissue tumours, predicted instability, while a posterolateral approach (OR 0.09, 95% CI 0.01 to 0.53) was protective against instability. No instability occurred when a synthetic graft was used in 70 patients. CONCLUSION: Stability of the hip after PFA is influenced by variables associated with the patient, the pathology, the surgical technique and the implant. We did not find an association between capsular repair and improved stability. Extension of the tumour often dictates surgical technique; however, our results indicate that PFA using a posterolateral approach with a hemiarthroplasty and synthetic augment for soft-tissue repair confers the lowest risk of instability. Patients who are elderly, female, or with a primary benign or malignant bone tumour should be counselled about an increased risk of instability. Cite this article: 2017;99-B:531-7.
[Mh] Termos MeSH primário: Artroplastia de Quadril/métodos
Neoplasias Femorais/cirurgia
Luxação do Quadril/etiologia
Prótese de Quadril
Instabilidade Articular/etiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/efeitos adversos
Criança
Pré-Escolar
Feminino
Neoplasias Femorais/secundário
Seguimentos
Seres Humanos
Cápsula Articular/cirurgia
Masculino
Meia-Idade
Desenho de Prótese
Estudos Retrospectivos
Fatores de Risco
Fatores Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170502
[Lr] Data última revisão:
170502
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170408
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B4.BJJ-2016-0960.R1


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[PMID]:28235114
[Au] Autor:Matsuda DK; Gupta N; Khatod M; Matsuda NA; Anthony F; Sampson J; Burchette R
[Ad] Endereço:Department of Orthopedics, DISC Sports and Spine Center, Marina del Rey, CA. dmatsuda@discmdgroup.com.
[Ti] Título:Poorer Arthroscopic Outcomes of Mild Dysplasia With Cam Femoroacetabular Impingement Versus Mixed Femoroacetabular Impingement in Absence of Capsular Repair.
[So] Source:Am J Orthop (Belle Mead NJ);46(1):E47-E53, 2017 Jan/Feb.
[Is] ISSN:1934-3418
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To compare outcomes of mild dysplasia with cam femoroacetabular impingement (FAI) vs mixed FAI with hip arthroscopy without capsular repair. METHODS: A retrospective review of a 2009 to 2010 multicenter prospective outcome study was performed comparing a cohort with mild dysplasia and cam femoroacetabular impingement (cohort D) to a cohort with mixed FAI (cohort M). Outcome measures included Nonarthritic Hip Score (NAHS) and satisfaction with minimum 2-year follow-up. RESULTS: Of 150 patients/159 hips enrolled in the initial prospective outcome study, 10 patients/10 hips had acetabular dysplasia and 8 patients met the inclusion criteria. Cohort D had 8 patients (5 female) of mean age 49.6 years with mean lateral center-edge angle (LCEA) of 19° (range, 16°-24°) demonstrating a mean change in NAHS of +20.00 at 3 months (P = .25), +14.33 at 12 months (P = .03), and -0.75 at 24 months (P = .74). Mean satisfaction was 2.88 out of 5. Cohort M had 69 patients (32 female) of mean age 38.6 years with a mean LCEA of 33° (range, 25°-38°) demonstrating a mean change in NAHS of +12.09 at 3 months (P < .0001), +20.39 at 12 months (P < .0001), and +21.99 at 24 months (P < .0001). Mean satisfaction was 3.58 out of 5. Cohort D demonstrated significantly less improvement in NAHS (P = .002) and a difference of -31.06 points compared to cohort M at minimum 2-year follow-up. Dysplasia was the only statistically significant predictor of poorer outcomes. CONCLUSION: The common combination of mild dysplasia and cam FAI has poorer outcomes than mixed FAI following arthroscopic surgery without capsular repair.
[Mh] Termos MeSH primário: Impacto Femoroacetabular/cirurgia
Luxação do Quadril/cirurgia
Articulação do Quadril/cirurgia
Cápsula Articular/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Impacto Femoroacetabular/complicações
Luxação do Quadril/complicações
Seres Humanos
Masculino
Meia-Idade
Satisfação do Paciente
Estudos Prospectivos
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE


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[PMID]:28235113
[Au] Autor:Friel N; Ukwuani G; Nho SJ
[Ad] Endereço:Department of Orthopedic Surgery, Division of Sports Medicine, Hip Preservation Center, Rush University Medical Center, Chicago, IL. nicolefriel@gmail.com.
[Ti] Título:Current Techniques in Treating Femoroacetabular Impingement: Capsular Repair and Plication.
[So] Source:Am J Orthop (Belle Mead NJ);46(1):49-54, 2017 Jan/Feb.
[Is] ISSN:1934-3418
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Management of the hip capsule has evolved with increased awareness that capsular closure during hip arthroscopy restores the normal anatomy of the ilio-femoral ligament and therefore restores the biomechanical characteristics of the hip joint. Both anatomical and clinical studies have found that capsular closure or plication after hip arthroscopy restores normal motion and allows patients to return to activity more quickly. Capsular closure is technically challenging and increases operative time, but gross instability and microinstability can be avoided with meticulous closure/plication. In this article, we describe capsular closure of a T-capsulotomy and an extensile interportal capsulotomy.
[Mh] Termos MeSH primário: Artroscopia/métodos
Impacto Femoroacetabular/cirurgia
Articulação do Quadril/cirurgia
Cápsula Articular/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Instabilidade Articular/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE


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[PMID]:28217895
[Au] Autor:Krasnokutsky S; Oshinsky C; Attur M; Ma S; Zhou H; Zheng F; Chen M; Patel J; Samuels J; Pike VC; Regatte R; Bencardino J; Rybak L; Abramson S; Pillinger MH
[Ad] Endereço:New York University School of Medicine, New York, New York.
[Ti] Título:Serum Urate Levels Predict Joint Space Narrowing in Non-Gout Patients With Medial Knee Osteoarthritis.
[So] Source:Arthritis Rheumatol;69(6):1213-1220, 2017 Jun.
[Is] ISSN:2326-5205
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The pathogenesis of osteoarthritis (OA) includes both mechanical and inflammatory features. Studies have implicated synovial fluid uric acid (UA) as a potential OA biomarker, possibly reflecting chondrocyte damage. Whether serum UA levels reflect/contribute to OA is unknown. We investigated whether serum UA levels predict OA progression in a non-gout knee OA population. METHODS: Eighty-eight patients with medial knee OA (body mass index [BMI] <33 kg/m ) but without gout were studied. Baseline serum UA levels were measured in previously banked serum samples. At 0 and 24 months, patients underwent standardized weight-bearing fixed-flexion posteroanterior knee radiography to determine joint space width (JSW) and Kellgren/Lawrence grades. Joint space narrowing (JSN) was calculated as the change in JSW from 0 to 24 months. Twenty-seven patients underwent baseline contrast-enhanced 3T knee magnetic resonance imaging for assessment of synovial volume. RESULTS: Serum UA levels correlated with JSN values in both univariate (r = 0.40, P < 0.01) and multivariate (r = 0.28, P = 0.01) analyses. There was a significant difference in mean JSN after dichotomization at a serum UA cut point of 6.8 mg/dl, the solubility point for serum urate, even after adjustment (JSN of 0.90 mm for a serum UA ≥6.8 mg/dl and 0.31 mm for a serum UA <6.8 mg/dl; P < 0.01). Baseline serum UA levels distinguished progressors (JSN >0.2 mm) and fast progressors (JSN >0.5 mm) from nonprogressors (JSN ≤0.0 mm) in multivariate analyses (area under the receiver operating characteristic curve 0.63 [P = 0.03] and 0.62 [P = 0.05], respectively). Serum UA levels correlated with the synovial volume (r = 0.44, P < 0.01), a possible marker of JSN, although this correlation did not persist after controlling for age, sex, and BMI (r = 0.13, P = 0.56). CONCLUSION: In non-gout patients with knee OA, the serum UA level predicted future JSN and may serve as a biomarker for OA progression.
[Mh] Termos MeSH primário: Cápsula Articular/patologia
Articulação do Joelho/patologia
Osteoartrite do Joelho/sangue
Ácido Úrico/sangue
[Mh] Termos MeSH secundário: Biomarcadores/sangue
Progressão da Doença
Feminino
Seres Humanos
Cápsula Articular/diagnóstico por imagem
Articulação do Joelho/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
Masculino
Meia-Idade
Análise Multivariada
Osteoartrite do Joelho/patologia
Valor Preditivo dos Testes
Curva ROC
Radiografia/métodos
Suporte de Carga
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 268B43MJ25 (Uric Acid)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170221
[St] Status:MEDLINE
[do] DOI:10.1002/art.40069



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